Basic Information
Provider Information
NPI: 1780665620
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VRIEND
FirstName: CATHERINE
MiddleName: A.Y.
NamePrefix: DR.
NameSuffix:  
Credential: PH.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 414 ADAMS ST
Address2:  
City: SAN ANTONIO
State: TX
PostalCode: 782101437
CountryCode: US
TelephoneNumber: 2105332672
FaxNumber:  
Practice Location
Address1: 3851 ROGER BROOKE DR
Address2: MCHE-QD (CREDS)
City: FORT SAM HOUSTON
State: TX
PostalCode: 782344501
CountryCode: US
TelephoneNumber: 2109161982
FaxNumber: 2109164040
Other Information
ProviderEnumerationDate: 11/08/2005
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103TC0700X31265TXY Behavioral Health & Social Service ProvidersPsychologistClinical

No ID Information.


Home